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3D printing might save your life one day. It's transforming medicine and health care.
What can 3D printing do for medicine? The "sky is the limit," says Northwell Health researcher Dr. Todd Goldstein.
- Medical professionals are currently using 3D printers to create prosthetics and patient-specific organ models that doctors can use to prepare for surgery.
- Eventually, scientists hope to print patient-specific organs that can be transplanted safely into the human body.
- Northwell Health, New York State's largest health care provider, is pioneering 3D printing in medicine in three key ways.
Imagine that a health emergency strikes and you need an organ transplant – say, a heart. You get your name on a transplant list, but you find out there's a waiting period of six months. Tens of thousands of people find themselves in this dire situation every year. But 3D printing has the potential to change that forever.
The technology could usher in a future where transplantable organs can be printed not only cheaply, but also to the exact anatomical specifications of each individual patient.
What other innovations could 3D printing bring to medicine and health care? The sky is the limit, according to Dr. Todd Goldstein, a researcher with the corporate venturing arm of Northwell Health, New York State's largest health care provider and an industry leader in 3D-printing research and development.
"It comes down to what people can think up and dream up what they want to use 3D printing for," Goldstein says. "Ideally, you would hope that 50 years from now you'd have on-demand, 3D printing of organs."
While that's still on the horizon for researchers, 3D printing is already improving lives by revolutionizing medicine in three key areas.
Printing realistic, customized organ models
3D printers can take images from MRI, PET, sonography or other technologies and convert them into life-size, three-dimensional models of patients' organs. These models serve as hands-on visualization tools that help surgeons plan the best approaches for complex procedures.
They also allow doctors to customize patient-specific models prior to surgery. For example, Northwell employs 3D printing in several clinical applications:
- Tumor resection models clearly highlight the tumor and surrounding tissue
- Orthopedic models are useful for pre-surgery measuring and medical device adjustments
- Vascular models identify malformations in organs, tumors, sliced chambers, blood flow, valves, muscle tissue, and calcifications
- Dentistry oral implants and appliances can be created in just one day, significantly reducing wait periods for Northwell dentists and their patients
Using realistic models not only delivers better health results but also shortens operating times. That gives patients less time under anesthesia, and hospitals potential savings of millions of dollars over just a few years.
Being able to visualize procedures before they occur also helps to comfort patients and their families. Take, for instance, the case of Barnaby Goberdhan, a man who discovered that his young son, Isaiah, had an aggressive tumor in his palate. Goberdhan met with Neha A. Patel, MD, a pediatric otolaryngologist at Cohen Children's Medical Center, a Northwell Health hospital, to discuss the procedure and learn about it with help from a 3D-printed model.
"Having a 3D printed depiction of my son was really helpful when talking with the doctor about his surgery," said Mr. Goberdhan. "The doctor was able to do more than talk me through what they were going to do – Dr. Patel showed me. There is almost nothing more frightening and stressful than having your child go through surgery. There were several options Dr. Patel walked us through for the best way to preserve Isaiah's teeth and prevent additional cuts within his mouth. I wanted all of my questions answered so I could be less fearful and more prepared to talk my son through what he was about to face. I wanted Isaiah to feel prepared. With the 3D model, we both felt more at ease."
For years, 3D printing surgical models was prohibitively expensive. Now, more affordable systems such as Formlabs' Form Cell give more hospitals across the country access to the technology in order to produce realistic, patient-specific models, usually within one day.
Credit: Northwell Health
While 3D-printed organs are a long way in the future, today's technology is well suited for manufacturing prosthetics. 3D-printed prosthetics are often remarkably more affordable and personalized than their traditional counterparts. That's a big deal for many families, especially those with children who outgrow prosthetics and are forced to buy new ones.
One recent breakthrough in 3D-printed prosthetics came when Dan Lasko, a former Marine who lost the lower part of his left leg in Afghanistan, wanted the ability to swim with his prosthetic leg. Wearing prosthetics in water has been possible for years, but they typically slow swimmers down. No device had been able to go seamlessly from land to water or to help propel its wearer through the water.
To fix that, Northwell Health recently funded a project that developed The Fin – the world's first truly amphibious prosthetic. With The Fin, Lasko and his family can go straight into the pool from the locker room – or the diving board.
"I got back in the pool with my two young sons and for the first time was able to dive into the pool with them," Lasko said.
3D-printed prosthetics will help improve the daily lives of the nearly 2 million Americans who've lost a limb. That's promising because the increasing prevalence of Type 2 diabetes is expected to greatly increase the number of amputees in the U.S., according to a study published in the Archives of Physical Medicine and Rehabilitation.
For years, 3D printers have manufactured various products: phone cases, toys, and even operational guns. To produce these objects, the machines heat a raw material, typically plastic, and build the object layer-by-layer according to a particular design.
3D bioprinting, a young field developed by researchers with Northwell Health, may someday perform the same process but instead with living cells in a raw material called bioink.
Daniel A. Grande, director at the Orthopedic Research Laboratory in the Feinstein Institute for Medical Research, an arm of Northwell Health, said he and his team first pursued 3D bioprinting by modifying 3D printers so they'd accept living cells.
"My initial concept of 3D printing was early studies that looked at modifying ink-jet printers, where we incorporate a bioink that includes cells within a delivery vehicle," Grande says. "That hydrogel can then be polymerized, or hardened, upon heat or UV-light stimulation, so that we can actually make a complex structure, three-dimensionally, that incorporates living cells. The hardened hydro-gel is then able to keep the cells alive and viable. It's also biocompatible, so it can be safely implanted in humans."
It's a promising enterprise, and it can radically change how we experience medical care.
"3D bioprinting's potential is almost limitless and has the potential to replace many different parts of the human body," says Michael Dowling, president and CEO at Northwell Health, and author of Health Care Reboot. "Researchers envision a future with 3D printers in every emergency room, where doctors are able to print emergency implants of organs and bones on demand and revolutionize the way medicine is practiced."
Dr. Todd Goldstein explains more about 3D bioprinting below:
Pandemic rumors and information overload make separating fact from fancy difficult, putting people's health and lives at risk.
The dark side of the information age<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzU1NzYwMi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNjE3MzY3Nn0.0HveQP16MbMkj9HXE8miohSHXETOak7oFDtBdXtE7lM/img.jpg?width=1245&coordinates=0%2C400%2C0%2C256&height=700" id="60d48" class="rm-shortcode" data-rm-shortcode-id="9085c1a7d5b3f81344c3002acdf1df68" data-rm-shortcode-name="rebelmouse-image" />
A South Korean church became a viral hotspot after church officials sprayed a salt water "cure" in congregants mouths, without disinfecting the nozzle between uses.
The cure for bad information is good<div class="rm-shortcode" data-media_id="e0tfZ3YB" data-player_id="FvQKszTI" data-rm-shortcode-id="601aa46855087a4dfcf02a67a160e0c4"> <div id="botr_e0tfZ3YB_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/e0tfZ3YB-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/e0tfZ3YB-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/e0tfZ3YB-FvQKszTI.js"></script> </div> <p><strong></strong><strong></strong>That doesn't mean we are defenseless. The best cure for rumors, stigma, and conspiracy theories is good, evidence-based information. We just have to know how to recognize it when we find it. Unfortunately, that's difficult in the center of the infodemic vortex.</p><p>"Information overload is incredibly anxiety-provoking—which is true even when the information is accurate," Jaimie Meyer, a Yale Medicine infectious diseases specialist, <a href="https://www.yalemedicine.org/stories/covid-19-infodemic/" target="_blank">told <em>Yale Medicine</em></a>. "But here, if people get the wrong information from unreliable sources, we may have more trouble slowing the spread of the virus. And we can't afford to get this wrong."</p><p>In their study, the researchers concluded that governments and health agencies should study the patterns of pandemic rumors, track the misinformation, and develop communication strategies to circumvent these messages. </p><p>In the <em>Yale Medicine </em>article, Meyer provides advice for helping individuals deal with information overload. She recommends looking at data and graphs carefully, considering how individual studies connect with established facts, and considering the whole story (not just the eye-catching headline). </p><p>When it comes to garnering information from social media, proceed with caution.</p><p>"Everything looks the same on Twitter," Meyer said. "When you have a tweet from Anthony Fauci, MD, director of the National Association of Allergy and Infectious Diseases, next to a tweet that says the opposite thing from a celebrity or some random person—and they all appear similar, you have to weigh the credibility of your sources." </p><p>She recommends following health agencies like <a href="https://twitter.com/who?lang=en" target="_blank" rel="noopener noreferrer dofollow">the WHO</a>, <a href="https://twitter.com/CDCgov?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor" target="_blank" rel="noopener noreferrer dofollow">the Centers for Disease Control and Prevention</a>, and your local and state health agencies. When you come across a pandemic rumor or something that seems suspect, you can double-check it against these authoritative sources, such as the WHO's <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters" target="_blank" rel="noopener noreferrer dofollow">COVID-19 mythbusters page</a>. And if you find yourself stressing out over the news and your social media feed, <a href="https://bigthink.com/mind-brain/mental-health-activities-coronavirus-lockdown" target="_self" rel="dofollow">take a mental break</a>.</p><p>We all would like a return to some form of normalcy, but that return will not emanate from a miracle cure. It will be a slow, steady course of handwashing, social distancing, and learning to navigate the infodemic.</p>
Carbon locked in soils can be emitted by bacteria.Turning up the heat on them releases more carbon.
- A new study shows that an increase in temperature can increase the amount of carbon released by the soil.
- This is in line with previous studies, though this one demonstrates a larger increase than the older experiments.
- The risk is that increasing temperatures cause a positive feedback loop.
The dirty details of an aggravated carbon cycle<div class="rm-shortcode" data-media_id="CabkeAzx" data-player_id="FvQKszTI" data-rm-shortcode-id="169377c88f392a86f6c42180b74820a5"> <div id="botr_CabkeAzx_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/CabkeAzx-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/CabkeAzx-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/CabkeAzx-FvQKszTI.js"></script> </div> <p>There is a lot of carbon in the dirt. The world's soil contains more carbon than the atmosphere, all the plants, or all the animals<a href="https://blogs.ei.columbia.edu/2018/02/21/can-soil-help-combat-climate-change/" target="_blank"></a>. A third of this trove of carbon resides in the soils of the <a href="https://www.sciencetimes.com/articles/26866/20200813/tropical-soils-highly-sensitive-climate-change.htm" target="_blank">tropics</a>. Under normal circumstances, this works as a carbon <a href="https://earthobservatory.nasa.gov/features/CarbonCycle" target="_blank">sink</a>, keeping carbon in storage and out of the atmosphere. Some of this carbon is used by bacteria in the soil to provide the building blocks of new microbes. They expel surplus carbon into the atmosphere in the form of carbon dioxide. </p><p>Many of these microbes are known to be more active when exposed to higher temperatures. To determine what this could mean for carbon emissions, a team from The University of Edenborough and the Smithsonian Tropical Research Institute turned up the heat in tropical soils to see what would happen. </p><p>The researchers went to an undisturbed plot of forest on Barro Colorado Panama, the home of the Smithsonian's Tropical Research Institute. They placed heating rods just over a meter into the soil and turned up the heat, warming the earth by four degrees centigrade. They then measured the carbon emissions from the heated ground and another nearby patch left at ambient temperature. These measurements covered two years.</p><p>Their findings, published in <a href="https://www.nature.com/articles/s41586-020-2566-4" target="_blank">Nature</a>, show that the heated soil emitted 55% more carbon than the control plot<a href="https://www.sciencedaily.com/releases/2020/08/200812144102.htm" target="_blank" rel="noopener noreferrer dofollow"></a>. <br> <br> Study lead author Andrew Nottingham commented on these findings to the <a href="https://phys.org/news/2020-08-global-tropical-soils-leak-carbon.html" target="_blank" rel="noopener noreferrer dofollow">AFP</a>. "Carbon held in tropical soils is more sensitive to warming than previously recognized. Even a small increase in respiration from tropical forest soils could have a large effect on atmospheric CO<sub>2</sub> concentrations, with consequences for global climate."</p><p>You can probably also spot the potential feedback loop here: If the global temperature increases too much, more carbon will be released from tropical soils, which then increase the greenhouse effect, which causes global temperatures to rise. </p>
Once is happenstance, twice is a coincidence, thrice is evidence of a pattern.<div class="rm-shortcode" data-media_id="8PLWDgcM" data-player_id="FvQKszTI" data-rm-shortcode-id="378380d273bf4a1c9606370acea15e58"> <div id="botr_8PLWDgcM_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/8PLWDgcM-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/8PLWDgcM-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/8PLWDgcM-FvQKszTI.js"></script> </div> <p>Previous studies on this topic point in the same direction. Those studies and the models they inspired suggested that increased temperatures could increase soil-based carbon emissions, but they all underestimated how much carbon would be involved.</p><p>A 2016 study focusing on temperate soils also concluded that increasing soil temperatures would increase their carbon <a href="https://www.nature.com/articles/nature20150" target="_blank">emissions</a>. They predicted that, if left unchecked, these emissions would equal the amount produced by a country similar to the United States over the next few <a href="https://www.ucsusa.org/resources/each-countrys-share-co2-emissions" target="_blank" rel="noopener noreferrer dofollow">decades</a>. Another experiment in Colorado found similar <a href="https://science.sciencemag.org/content/355/6332/1420" target="_blank" rel="noopener noreferrer dofollow">results</a>. Both of these studies found lower increases in carbon emissions by percentage than the study on Barro Colorado. </p><p>However, these studies did not take place in the tropics, and the differences in the soils between temperate and tropical zones could explain the differences between the studies. Moreover, the dirt on Barro Colorado Island differs from the dirt in the Amazon and may be more inclined to produce more emissions when the heat is turned up. The same can be said of tropical soils <a href="https://www.nytimes.com/2020/08/12/climate/tropical-soils-climate-change.html?searchResultPosition=3&utm_campaign=Hot%20News&utm_medium=email&_hsmi=93170710&_hsenc=p2ANqtz-8McWKRhE8U9ChcWW2qkqNyp2Qndzr1aJmGlrMUwK_h1bM8RDQukWcM8r2OcBKW2Y0bWlRr9o4WUixKDzIo4HzKkVv19g&utm_content=93170710&utm_source=hs_email" target="_blank" rel="noopener noreferrer dofollow">elsewhere</a>. </p><p>Another <a href="https://www.forestwarming.org/" target="_blank" rel="noopener noreferrer dofollow">experiment</a>, very similar to the one in Panama, is currently underway in Puerto Rico. However, this experiment is taking the extra step of also heating the plants near the heated soil to see what the effect of warmer temperatures is on their ability to absorb carbon.</p><p>The current study also did not heat the soil past the one-meter mark and cannot provide us with predictions of what more comprehensive heating of the soil would do to emissions. It was also comparatively short, and the effect may be reduced in the long run as the nutrients in the soil are depleted by the increased activity of the microbes, which are using the carbon and other resources to <a href="https://www.nature.com/articles/d41586-020-02266-9" target="_blank" rel="noopener noreferrer dofollow">reproduce</a>. </p><p>The team behind the most recent study will continue their experiment to try and understand how tropical ecosystems respond to increased <a href="https://www.earth.com/news/billions-of-tons-of-co2-could-be-released-from-tropical-soils/" target="_blank" rel="noopener noreferrer dofollow">temperatures</a> over more extended periods of time. </p><p>As we increase our understanding of the planet and its various environmental systems, the potential consequences of climate change become clearer and more horrifying. This new study supports previous findings that suggest disrupting soils can increase carbon emissions. While it may be too soon to tell if the eye-popping increases found by this study are typical or an outlier, they do re-enforce the notion that a breakdown in the systems that keep the climate stable is possible if nothing changes. </p>
A study published Friday tested how well 14 commonly available face masks blocked the emission of respiratory droplets as people were speaking.
- The study tested the efficacy of popular types of face masks, including N95 respirators, bandanas, cotton-polypropylene masks, gaiters and others.
- The results showed that N95 respirators were most effective, while wearing a neck fleece (aka gaiter) actually produced more respiratory droplets than wearing no mask at all.
- Certain types of homemade masks seem to be effective at blocking the spread of COVID-19.
Fischer et al.<p>A smartphone camera recorded video of the participants, and a computer algorithm counted the number of droplets they emitted. To establish a control trial, the participants spoke into the box both with and without a mask. And to make sure that the droplets weren't in fact dust from the masks, the team conducted more tests by "repeatedly puffing air from a bulb through the masks."</p>
Fischer et al.<p>The results, published Friday in <a href="https://advances.sciencemag.org/content/early/2020/08/07/sciadv.abd3083" target="_blank">Science Advances</a>, showed that some masks are pretty much useless. In particular, neck fleeces (also called gaiters) actually produced more respiratory droplets compared to the control trial — likely because the fabric breaks down big droplets into smaller ones.</p><p>The top three most effective masks were N95 respirators, surgical masks and polypropylene-cotton masks. Bandanas performed the worst, but were slightly better than wearing no mask at all.</p>
Fischer et al.<p>Research on mask efficacy is still emerging. But the new results seem to generally align with <a href="https://newsroom.wakehealth.edu/News-Releases/2020/04/Testing-Shows-Type-of-Cloth-Used-in-Homemade-Masks-Makes-a-Difference" target="_blank" rel="noopener noreferrer dofollow">prior tests</a>. For example, a study from June published in <a href="https://aip.scitation.org/doi/10.1063/5.0016018" target="_blank" rel="noopener noreferrer dofollow">Physics of Fluid</a> found that bandanas (followed by folded handkerchiefs) were least effective at blocking respiratory droplets. That same study also found, as <a href="https://newsroom.wakehealth.edu/News-Releases/2020/04/Testing-Shows-Type-of-Cloth-Used-in-Homemade-Masks-Makes-a-Difference" target="_blank" rel="noopener noreferrer dofollow">others have</a>, that masks made from multiple layers of quilter's fabric were especially effective at blocking droplets.</p><p>The researchers hope other institutions will conduct similar experiments so the public can see how well different masks can block the spread of COVID-19.</p><p style="margin-left: 20px;">"This is a very powerful visual tool to raise awareness that a very simple masks, like these homemade cotton masks, do really well to stop the majority of these respiratory droplets," Fischer told CNN. "Companies and manufacturers can set this up and test their mask designs before producing them, which would also be very useful."</p>
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